Anterior mediastinal masses resection with cosmetic skin approach

The objective of this study was to describe a cosmetic skin incision for resection of large anterior mediastinal masses, and to review our experience with this technique.

From 1999 to 2010, 55 patients with a diagnosis of large anterior mediastinal masses underwent "goblet"-shaped skin incision with midline sternotomy. The complications, mortality, details of surgery, and duration of hospital stay were observed from review. Patients were monitored via follow-up for a duration of one year after surgery.

The mean hospital stay was nine days. Wound complications of infection were observed in one patient. There were no other complications, such as hematoma formation, necrosis of skin flap, split or infection of the sternum. No related mortality was recorded within the 30-day postoperative period. All of the patients verbalized the benefits of this technique, particularly the possibility of wearing open-collared clothing, as a result of the cosmetic chest wall and a camouflaging scar below the angle of Louis. At the follow-up periods, 52 of the patients were found to be well. Three patients did not complete follow-up at our facility.

Our primary experience with this procedure proved it was safe. The technique allows excellent access to the mediastinum and complete removal of large anterior mediastinal masses that are complicated with adjacent midline cardiovascular structures. This technique also provides a better cosmetic result than the standard vertical incision.